5 cases of orthotopic live transplantation (OLTX) were performed in unresectable hepatic cellular carcinoma(3),Wilson's disease(1)and hepatitis B(1).The donor livers were harvested by the technique of rapid multiple organ harvesting,flushed and preserved with UW solution.The veno-venous bypass was introduced during the anhepatic phase in the operation.The double or triple-drug immunosuppressive regimen was used and three episodes of acute rejection were controlled in two patients.One patient died of CMV infection and another,of upper gastrointestinal hemorrhage on the 92nd and 58th postoperative day respectively.The other three are still alive for 35,150 and 210 days.

Objective To study the effect of simultaneously combined liver and kidney transplantation (SLKT) on end-stage liver and kidney diseases. Methods Thirteen cases subject to SLKT from 1996 to 2004 were reviewed in The First Affiliated Hospital of Sun Yat-sen University. Among them, there were 4 cases of polycystic liver and kidney, 4 cases of hepatic cirrhosis and renal failure, and 5 cases of fulminant heptic failure and hepatorenal syndrome. Ten were males and 3 females with an average age of 45.5 years old.Results Four cases of polycystic liver and kidney have all survived for more than one year after SLKT, and one of them has survived for 4 years. The 3 of 4 patients with hepatic cirrhosis and renal failure have survived more than one year, and one of them died perioperatively. The 2 of 5 patients with fulminant hepatic failure and hepatorenal syndrome have survived for one year, and 3 of them died perioperatively.Conclusion SLKT has been the effective therapy for end-stage liver and kindney diseases; The indications of SLKT for hepato-renal syndrome were discussed. SLKT may immunologically protect the renal graft.

Objective To investigate the surgical technique of establishing a reliable rat model of orthotopic liver transplantation and prevention of operational complication. Methods The model was established with modified cuff technique.The donor was perfused through the abdominal aorta with 20ml cold perfusate.The anastomosis of the suprahepatic vena cave(VC)was sutured end-to-end with 8-0 nylon line,and the continuity of infrahepatic VC and portal vein (PV)were established by means of cuff method respectively.The bile duct anastomosis was performed by internal stent. Results Three hundred and sixty case of rat orthotopic liver transplantation were performed and the successful rate of the mode was 91.3%.In non-intervention group,the survival rat was satisfactory,with a 86.5%of 1 week survival and a 80.7% of long-term survival (longer than 3 months). Conclusions The sophisticated microsurgical technique and the delicate surgical manipulation is the prerequisite of preventing operational complication,and shortening the anhepatic phase of recipient as soon as possible is the key to animal survival.

Objective To investigate the distribution of traditional Chinese medicine (TCM) syndrome types of functional dyspepsia (FD) in Guangzhou, and to explore their correlation with some factors such as residence time in Guangzhou, gender, age, and Helicobacter pylori (Hp) infection. Methods A total of 326 cases of FD patients from Guangzhou were investigated. Database of the related clinical data was built and analyzed. Results The commonly-seen TCM syndrome types of FD patients in Guangzhou were spleen-deficiency and qi stagnation, disharmony of liver and stomach, dampness-heat of spleen and stomach, deficiency-cold in spleen and stomach, and concurrence of cold and heat, accounting for 41.71%, 26.07%, 11.96%, 11.04% and 9.20%, respectively. There were significant differences among the TCM syndromes(P < 0.05). The differences of average age of onset, residence time in Guangzhou, FD subtypes and Hp infection were significant among each syndrome type (P < 0.05). Conclusion The distribution of TCM syndrome types of FD in Guangzhou is dominated by spleen-deficiency and qi stagnation, and the syndrome types are correlated with residence time in Guangzhou, gender, average age of onset, FD subtypes, and Hp infection.

Objective To sum up the clinical experience of liver retransplantation (ReTx).Methods All recipients were male. The average age was 50 years old (43-55). The indications included primary nonfunction (PNF) (1 case), acute rejection (1 case), chronic rejection and biliary infection (1 cases) and ischemic type billiary lesion and biliary infection (2 cases). The blood types of recipients and donors were identical. All donors were heart arrest. The immunosuppressive protocols included Zenapax and methylpredinisone (MP) and FK506. MMF was added if necessary.Results Three patients were cured. Two patients died at 8th and 10th day. One died of serious infection and failure of multiple organs and another died of heart failure. Complications included multiple organ infection (1 case) and biliary infection (1 case) and wound infection (1 case).Conclusion Liver retransplantation is an effective treatment for graft failure after liver transplantation. Proper indication and optimum operation time, intensive perioperative supervision and proper treatment were very important for improved effect of liver retransplantation.

Hepatic ischemia/reperfusion injury (HIRI) exists in lots of process of clinical pathology and operation. Apoptosis is an active process controlled by some gene and factors such as Fas/FasL, Caspases and Bcl-2 families. More and more studies suggest that HIRI is associated with apoptosis. This article summarized the mechanisms and gene modulation of apoptosis during HIRI and the significance of suppressing apoptosis in preventing HIRI.

Objective To evaluate the effect of smecta on acute gastroenteritis induced by the radiotherapy in human cervical cancer.Methods seventy-eight patients under radiotherapy received smecta combined with general medicine to control gastroenteritis. All patients were divided into 2 groups:group A: 40 patients were treated with smecta and general medicine.group B:38 patients were only routinely treated. The routine medicine included prednisone, vitamin B 2 and ciprofloxacin.Results The effective rate for acute gastroenteritis in A group was significant higher than in B group ( P

Objective:To observe the effect of dexmedetomidine used in ophthalmic surgery anesthesia on the recovery quality in children. Methods:Totally 126 children with ophthalmic surgery were randomly divided into the control group and the observation group with the same induction program. The control group was given propofol with target controlled infusion during the operation, while the observation group was given dexmedetomidine 0. 6μg·kg-1 before the induction, and infused up in 10min, propofol with target controlled infusion was used during the operation, and stopped infusion 10min before the end of the operation. The cough number and degree, the occurrence of agitation and extubation time of the two groups were observed and compared during the anesthesia recovery period. Results:The cough incidence and agitation incidence was 36. 51% and 4. 76% in the observation group, respectively, which were significantly lower than those in the control group (74. 60% and 33. 33%, P<0. 05). The cough degree between the two groups showed significant difference (P<0. 05). The first cough time and the extubation time between the two groups showed no significant difference (P>0. 05). Conclusion:Dexmedetomidine used in ophthalmic surgery anesthesia of children can effectively control cough frequency and degree during the recovery period and reduce the agitation to improve the quality of clinical anesthesia recovery.

Objective To study clinical features, diagnosis and treatment of allergic bronchopulmonary aspergillosis (ABPA) . Methods Clinical data and auxiliary examinations of eight patients with ABPA were analyzed, as well as relevant literatures were reviewed. Results All patients had symptom of cough, expectoration, out of breath and wheezing tale, seven of them with history of asthma, and all of them had increased peripheral blood eosinophil (EOS) count, serum levels of total immunoglobulin E (IgE) and lgE specific for Aspergillus fumigatus and showed positive prick test specific for Aspergillas fumigatus. Six of them showed infiltration shadows and six of them showed bronchiectasis in their chest CT images. Lung function test indicated obstructive ventilation dysfunction or mixed ventilation dysfunction with reversible airflow obstruction after administration of bronchodilator. Conclusions Diagnosis for ABPA should be made by integration of clinical features, increased blood eosinophil count and serum level of IgE, and result of prick test specific for Aspergillus fumigatus. Corticosteroid is a mainstay therapy for ABPA, ancillary with anti-fungi therapy. Patients with ABPA should be followed-up to prevent its recurrence.

Objective To observe recipient survival time and liver graft regeneration in an orthotopic liver transplantation model using IL-6 knockout mice as a donor.Methods A model of liver transplantation in C57BL/6 WT and IL-6 KO mice with C57BL/6 background was established.Thirty eight mice were divided into three groups:C57BL/6 wild type→C57BL/6 wild type control group(n=10),IL-6 KO→IL-6 KO group(n=14)and IL-6 KO→C57BL/6 WT group(n=14).Hepatocyte replication with BrdU uptake after liver transplantation was examined by immunohistochemistry.Resuits The survival time in the control group was＞16 days.and that was 2 days and 1.6 days in the IL-6 KO→IL-6 KO and IL-6KO→C57BL/6 WT,respectively.The difierence in survival time in all three groups was statistically significant(F=190.09,P＜0.01).The liver grafts in control group showed minimal injury and no necrosis and mild increase of BrdU uptake at 48 hours.Patchy areas of necrosis and hepatocyte ballooning were observed in the two groups using IL-6 KO mice as donors,there was minimum increase in BrdU uptake at 48 hours post transplantation.Conclusion IL-6 KO liver grafts fail to regenerate after liver transplantation.IL-6 is an important factor in liver regerative response.